From liquorice root
- appears to accelerate the healing of gastric ulcers
- significant side effects. Carbenoxelone and related compounds have a "mineralcorticoid" effect causing sodium and water retention which can lead to alkalosis, hypertension and hypokalaemia. It can precipitate glaucoma and urinary retention.

Describe use of SUCRALFATE for peptic ulcers.

- Basic aluminium salt of sulphated sucrose
- Viscous at acid pH and adheres to surface of ulcers, to act as a barrier to the aggressive luminal factors (acid, pepsin, bile salts)
- Antacids & meals should not be taken within half and hour of sucralfate as they may raise the gastric pH and alter the physicochemcial properties of sulcralfate
- SEs include constipation, interference with absorption of some drugs or long term Al toxicity effecting CNS, bone and kidneys.

Describe use of BISMUTH COMPOUNDS for peptic ulcers.

- Forms precipitate which binds to proteins on surface of ulcers at acidic pH providing barrier to aggressive factors in gastric juice.
- Batericidal to Helicobacter pyloris
- SEs - Ammoniacal odour & taste and causes black discoloration of the tongue and faeces, long term could damage kidneys and CNS
- Not to be taken with meals, antacids or other medication.